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22.—(1) Subject to paragraphs (2) and (3), an agreement under which essential services are to be provided must provide for the provision of out of hours services throughout the out of hours period unless—
(a)the Board has accepted in writing, prior to the signing of the agreement, a written request from the contractor that the agreement should not require the contractor to make such provision;
(b)the contractor has opted out of providing such services in the out of hours period in accordance with Part 6; or
(c)the agreement has been otherwise varied to exclude a requirement to make such provision.
(2) Except to the extent that the agreement otherwise provides, a contractor whose agreement includes the provision of out of hours services is only required to provide such services if, in the contractor’s reasonable opinion having regard to the patient’s medical condition, it would not be reasonable in all the circumstances for the patient to wait to obtain such services.
(3) Paragraph (4) applies to a contractor which—
(a)provides out of hours services to registered patients of another contractor or provider of essential services (or their equivalent); or
(b)has contracted to provide out of hours services to patients to whom it provides essential services.
(4) The contractor must, in the provision of those services—
(a)meet the quality requirements set out in the document entitled “National Quality Requirements in the Delivery of Out of Hours Services” published on 29th July 2006(1); and
(b)comply with any requests for information which it receives from, or on behalf of, the Board about the provision by the contractor of out of hours services to its registered patients in such manner, and before the end of such period, as is specified in the request.
(5) Where a contractor is a provider of essential services but is not required to provide out of hours services under the agreement or, under Part 6, has opted out of the provision of such services under the agreement, the contractor must—
(a)monitor the quality of the out of hours services which are offered or provided to its registered patients having regard to the National Quality Standards referred to in sub-paragraph (4) and record, and act appropriately in relation to, any concerns arising;
(b)record any patient feedback received, including complaints; and
(c)report to the Board, either at the request of the Board or otherwise, any concerns arising about the quality of the out of hours services which are offered or provided to patients to its registered patients having regard to—
(i)any patient feedback received, including any complaints; and
(ii)the quality requirements set out in the National Quality Standards referred to in paragraph (4).
The document entitled National Quality Standards in the Delivery of Out of Hours Services published on 20th July 2006 is available at http//www.dh.gov.uk/en/PublicationsAndStatistics/Publications/PolicyAndGuidance/DH_4137271. Hard copies of this document may be obtained from the Department of Health, Richmond House, 79 Whitehall, London SW1A 2NS.
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